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Monthly Archives: August 2013

Surely by now you’ve read the story about the dentist who bought John Lennon’s decayed molar at auction and now plans to extract DNA from it and clone the late, great Beatle. You’ve seen the clever headlines (the best of which was from Sharon Hill: Just Like Starting Over, With Another John Lennon), and the lame attempts at humor (admittedly I’m guilty of this):

— I’m fixing a hole where decay gets in…

— Imagingivitis

— I wanna clone your hand…

— You should see Polydent Pam…

— I cloned a tooth today, oh boy…

I’m here all week. Tip your waitress.

Yes, I know I’m behind the curve on this story, as it jumped the shark last week. However, as a dentist I feel it is my odontological duty to cobble together at least a half-assed blog post so that I don’t have to go stand by myself in shame at blog author parties. So here goes.

To summarize, in 2011 a Canadian dentist named Michael Zuk purchased one of John Lennon’s extracted teeth for around $31,200. By the looks of it, it needed to come out- a huge carious lesion (cavity) encompassed almost half of the tooth.

Ewwww.

While perhaps a bit eccentric and macabre, a dentist wanting to own a tooth that used to belong to perhaps the most famous rock musician in history is not that unthinkable; heck, I’d take it in a heartbeat. In fact, if I owned Lennon’s tooth, I’d parade it around like it was the fricking Magna Carta. But where it gets weird is that Dr. Zuk now has plans to extract the DNA from the molar and attempt to clone a brand-spanking-new John Lennon.

“I am nervous and excited at the possibility that we will be able to fully sequence John Lennon’s DNA, very soon I hope,” Zuk said in a statement on his John Lennon Tooth site. “With researchers working on ways to clone mammoths, the same technology certainly could make human cloning a reality.”

(Editors note: John’s hair style in the mid-1960s when this tooth was extracted resembled a wooly mammoth’s. Coincidence?)

OK, let’s get this out right at the beginning of the post so as not to create confusion or give Dr. Zuk more scientific credibility than he deserves. This is a publicity stunt, pure and simple. I’m sure Dr. Zuk is a fine man and an excellent dentist, but he is milking this thing for all it is worth. And I’m not blaming him or criticizing him at all; I’m just pointing this out so that no one gets the weird idea that there might soon be another John “Dolly” Lennon roaming the streets, gearing up for British Invasion v2.0. Ignoring for a moment the probable insurmountable biochemical challenges in extracting, amplifying, and actually cloning John’s DNA (not to mention the expense); one also has to consider the little things such as ethics, legal battles, ownership disputes, and so on. It ain’t gonna happen, folks. Michael Zuk will get his fifteen minutes of fame (which is equal to about eight Beatles songs), and he will somehow, some way get more than $31,200 worth of milage and publicity out of it. Consider it a smart and savvy marketing move on his part and good on him. I wish him the best.

But suppose Dr. Zuk couldovercome said obstacles. Suppose he owns a private island in the middle of the Pacific Ocean beyond the reach of any scientific or legal body, with the world’s best scientists and the latest technology and equipment at his disposal. How would he go about cloning “The Smart Beatle” (remember, George was the shy one, Paul was the cute one, Ringo was the sad one, and Pete Best was the colossal idiot one)? Here is a step by step, very basic primer on the cloning process of creating a John Lennon:

1. Relatively large, undamaged strands of DNA must be isolated and extracted from the pulp chamber (i.e. nerve) of the tooth. Historically, pulp chambers of animals are excellent reservoirs of genetic material due to the protection of the hard enamel. In John’s case, the pulp chamber would have been invaded by bacteria in the huge cavity, rendering it contaminated. Note: as cloning technology improves, complete strands of DNA will be able to be synthesized from a lot of smaller snippets; further, techniques for separating human DNA from bacterial or other contaminating DNA will improve as well.

2. OK, let’s say we were able to cobble together various chunks and we now have a full, intact strand of John’s DNA. Now what? Now we must make copies of this DNA. Using the Polymerase Chain Reaction (PCR) technique, the enzyme polymerase makes exact copies of the original strand(s) of DNA.

3. The next step is transfection, in which the scientist inserts the copied DNA into a host cell, often a cell from which the existing DNA has been removed.

4. Then there is some hocus pocus, hand waving, maybe a smoke bomb or two (actually they run a current through it and do other things), and the cell with the DNA is implanted into the surrogate with conventional IVF techniques.

(Disclaimer: I’m not a cloning expert, and I’m sure my simplistic explanation above is fraught with errors. But for our purposes, it gives a broad overview of how cloning occurs. Please forgive any mistakes on my part, and if you want to point them out on the comments page or by emailing me at feedback(at)prismpodcast.com, I’d appreciate it.)

So there you have it: a fun romp through music history and biotechnology.

I just hope that if and when this cloning feat occurs, science will have advanced enough so that the gene that was responsible for the abomination that is the “song” John and Yoko can be excised and forever destroyed. What’s up with that? YOU WERE A BEATLE, FOR CHRIST’S SAKE!!

I can hardly wait,To see (cloning) come of age,But I guess we’ll both,Just have to be patient,Yes it’s a long way to go…

Believe it or not, there are podcasts out there that are even better than the one Jason and I did a couple of weeks ago (#sarcasm). Among the many fine choices out there, RadioLab is consistently excellent and intriguing; it is invariably at the top of my listening queue. Recently, RadioLab did a show on a patient who survived rabies, which until recently was 100% fatal- a death sentence with no chance of commutation or reprieve from the Governor. The story itself is amazing, and you should stop reading here, take a brief intermission and go listen to it. I’ll be here when you get back.

OK, back? Pretty good, huh? Though I was transfixed during the entire episode, do you know what little tidbit of information stuck with me more than anything else? The off the cuff factoid that back in medieval times, one of the treatments for rabies was to pluck the feathers from around a rooster’s anus, then apply said anus to the animal bite, ostensibly to “suck out” the infection. Makes sense, eh? I mean, I’m no rooster anus aficionado, but I can imagine that it might resemble a suction cup sort of thing. These are some pretty weird dots to connect to be sure, but I guess that when faced with a potentially fatal disease, physicians back then tried anything and everything hoping to find that magical cure, even if by luck or trial and error. Without the scientific method, that’s pretty much all they had.

Why, I can hear you ask, whywould tincture of tush even continue as a recommended treatment after the first attempt or two? OK, I’ll give the doctor/barber/blacksmith the benefit of the doubt when thinking of it for the first time and giving it a go, but then after that? How could the doctor of yesteryear think this was a good idea? Did his success rate in treatment skyrocket after sphinctotherapy? How does one rationalize this?

Well, here’s how it went down, and the reason I’m bringing this up isn’t just because it’s a fun, quirky subject or that I have a thing about poultry and/or anuses. There are modern day applications of this same dysfunctional thought process, and the public must be made aware of these modern day purveyors of rooster anus therapies and their likes.

Suppose you’re this guy, the village doctor:

A frantic mother comes running into your office/stables with her 12 year old daughter in tow. The young girl has just been bitten by a mad dog and everyone knows what that means. Thinking quickly, you grab a rooster, pluck the feathers from around its anus (I’m sure there’s an insurance code for that), and apply buttsuction pressure to the wound stat. You then write a prescription to the mother like so:

After a week, you go and check up on the family; lo and behold! the girl is fine. No signs of rabies and the wound is healing well. When you get back to your office/stables, you look back over your notes and determine that your avian treatment protocol has roughly a 25% success rate. “That’s pretty good” you say. “If it weren’t for my quick thinking and medical acumen, they all would have died. This modern treatment of rabies is proof that we have truly made great advances in medical science. In my experience, rooster anus is the treatment of choice for rabies.”

So what is the reality here? Do sphincters possess medicative qualities? Was Yorick the doctor/barber/blacksmith on the right track?

No and no.

The reality is that while rabies is a horrible disease, it is only 100% (well, until recently at least) fatal once it has established a foothold in the host. Often, a person who is bitten by a wild animal doesn’t contract rabies at all. There are several possible explanations for this: 1. the animal didn’t have rabies to start with, 2. the bite didn’t break the skin, 3. the virus didn’t enter the bloodstream or other area where it could take up residence in the nerve tissue, or 4. the victim’s antibodies dispatched the viruses before they could cause harm.

There could be other explanations and scenarios, but you get the picture. While all rabies infections were 100% fatal, not all animal bites were. Dr. Yorick, of course, wasn’t aware of all the times a person was bit who subsequently remained healthy. His experimental group, as it were, consisted only of those who either had been bitten but not yet showed the signs of rabies or people with full-fledged rabies. The former group would naturally respond reasonably well to Rooster Anus Therapy®, not because of the rooster, but because that person stood a decent chance of remaining healthy anyway. Yorick naturally would take credit for the health of this subgroup. This fallacy in reasoning is called Post Hoc, Ergo Propter Hoc, which is similar to Affirming the Consequent. The logical structure goes something like this: P occured before Q. Q resulted, therefore P caused Q. Translated, this reads “If I put a rooster’s anus onto an animal bite, the patient will not contract rabies. The patient did not contract rabies. Therefore, rooster anus is effective and prevented the rabies.” This is where Yorick went wrong and relied only upon his experience, but you can’t blame the chap.

You can, however, blame the frauds, quacks, and ignorant practitioners of woo out there who peddle their own version of rooster anuses to a gullible and unsuspecting public. From homeopathy to acupuncture, to just about every kind of “complementary” or “integrative” therapies, they all work on the same Affirming the Consequent principle. You pressed, poked, stabbed, or shocked some alleged point on your body and your knee pain felt better? You swallowed a supplement and you slept better last night? You pressed a rooster anus to your squirrel bite and you didn’t get rabies? The delusional practitioner will think “In my experience, ________ has worked well.” This is very dangerous thinking.

Modern day alt-med thinking and medieval rooster thinking is pretty much the same thing.

Most health care practitioners worth their salt know this; however, a vast number of lay people, as well as many other health care providers either don’t know it or choose to ignore it because of some bias or agenda. Or perhaps they are outright charletans. However, it is the responsibility of every science minded individual to fight this type of thinking and challenge these dysfunctional practices wherever they occur.

Athletic mouthguards have been a staple of sports for decades; they provide a vital role in preventing injuries to the teeth and jaws as well as reducing the incidence and severity of concussions. In the past few years, however, the emergence of “performance mouthguards” has flooded the sports scene. These enhanced products claim to do more than merely protect the wearer; indeed, by positioning the mandible (lower jaw) into a specific position, the mouthguard is said to open the airway to increase oxygen intake, to relax jaw muscles ostensibly to prevent those contracting muscles from “robbing” other parts of one’s body’s energy (which allegedly decreases muscular efficiency elsewhere), and to trigger hormonal changes (chiefly by diminishing cortisol, the “stress hormone”, release). Big names such as Under Armour®, as well as smaller niche companies, dental labs, and others are invested in this concept, and millions are spent by athletes each year trying to get that extra edge that will allow them to rise above their competition.

Whether or not they do what they claim is not the purpose of this post (spoiler alert: probably not, but the jury is still out), but to alert our readers of a technique that dentists and other providers of these mouthguards employ to “demonstrate” the effectiveness of these expensive hunks of acrylic. Known as muscle testing or Applied Kinesiology, the practitioner will have the athlete clench his or her teeth, then perform tests such as pressing down on an extended arm, pushing the person to test for balance, and so on. Then the athlete will place something between his or her teeth- the mouthguard, a pencil, or a stick- and the tests are repeated. LO! The balance and strength is improved!

This is not a new trick. It was invented in the 1960s by a chiropractor, and is used for a myriad of uses, for example allergy testing whereby a patient holds a vial of a suspected allergen in his or her hand and the muscles are tested as described above; if there is weakness, then there must be an allergy or sensitivity for that particular substance. And no, I’m not making that up or pulling your leg. Recently, it has been showcased in “proving” the effectiveness of the Power Balance bracelet, debunked so beautifully by Richard Saunders. And now, it is been used to show that muscle strength and balance is improved with the use of these mouthguards. The sad thing is that I know many many dentists who believe in this “technology”, and I can attest to their honesty and sincere desire to help their patients. So in an overwhelming majority of cases, this is not an issue of fraud and deception (except for self-deception). It is merely ignorance of how the placebo effect, operator bias, and suggestibility works.

As with most fad gizmos, celebrity endorsements and patient testimonials are the cornerstone of the marketing approach undertaken by the producers of these products. After all , who needs a study when all you need is Shaq telling you that a mouthguard improved his free throw percentage (from 12% to 16%?)? And in a marketing coup, here is a photo from 2011 of Bill Gates being muscle tested for a mouthguard:

While there are a few small, poorly done studies (example here) that purport to show, if not outright effectiveness then a glimmer of biological and physiological plausibility, most of the perceived benefits can be attributed to biases on the part of the operator and recipient. A good overview of the process by Stephen Barrett can be found here, along with several references. Whether or not they eventually are shown to work, don’t rely on parlor tricks as evidence of effectiveness.

So, exercise caution when evaluating the claims of these so-called “performance mouthguards.” To be sure, the appliances themselves are of high quality and will do all the things a mouthguard is supposed to do, but they cost 1-2 orders of magnitude more, so buyer beware.

The “Skeptical Movement” has grown dramatically in the 3+ decades since it originated, particularly in the last ten years. Not unsurprisingly, with this growth has come factionization (is that a word?), splintering, and disagreements about goals, values, and purposes. In other words, it’s behaving like any large group of people. This movement has brought together some of the brightest, smartest, friendliest, and most creative minds in the world. However, it is inevitable that with such a large and diverse population of persons comes bickering, infighting, and disrespectful and boorish behavior. These past two years has seen a dramatic spike in controversy and offensive behavior, and the movement is threatened from within because of it.

I have been aware of the major issues confronting the Skeptical Movement and have observed them with peripheral vision. I am torn because I want to remain informed and not insensitive to the victims of such ill treatment, but I don’t want to be sucked into the dysfunctional morass, the games, or the politics.

Bob’s timely and optimistic post was a much needed positive ray of sunshine in a time where negativity and controversy has been in the forefront and monopolized the blogosphere, the Twittoverse, and Facebookopia. With his permission, below please find Bob’s full article. If you’re not familiar with his blog, do yourself a favor and make it part of your reading rotation. It can be found here. Thanks Bob!

What’s Right with Skepticism?

The last two weeks have been difficult for members of organized skepticism, a community that I have been increasingly involved in over the last five years. In that time, I’ve made a lot of good friends, but recently many of them have forgotten they can disagree without hating one another. This animosity threatens a lot of progress that has been made over the past decade, during which time groups of overwhelmingly like-minded people have found each other in order to promote evidence-based thinking and to celebrate curiosity and progress.

Yesterday, Newsweek published a piece by Michael Moynihan called, “James Randi, the Amazing Meeting, and the Bullshit Police.” I think it’s safe to say that most of it was probably written before the most recent flare up of “The Troubles,” because in some ways the portrait of skepticism represented in that article–with the veneer of a united movement–reminds me of someone with whom I am intimately familiar, but who is impossibly distant. It’s hard to believe that just a month ago, I was in the company of 1,500 friends from around the world, any one of whom I could easily plonk down next to and have a beer with.

I have a very good friend whom I’ll call Bob. Bob is a wonderful fellow: we share a warped sense of humor, we get into stimulating, deep conversations even when we haven’t been together in a while, and we both profess to be rational, evidence based individuals. We also like the same kind of rock music with a few minor differences; he leans more toward the Little River Band, England Dan and John Ford Coley, Firefall (i.e. crappy) end of the spectrum, while I prefer to melt my face with Zeppelin, The Who, and Alice Cooper (i.e. awesome). Rock climbing is a shared passion of ours, and we’ve had some amazing climbs together in Yosemite, Joshua Tree, and Malibu. He’s just a peach of a guy.

As most of us skeptical types already know, one of the hallmarks of being a good critical thinker and skeptic is the triad of attributes that lead to genuine inquiry, no matter what the subject. This triad consists of natural curiosity, questioning everything, and knowing how to ask the right questions. This is arguably the starting gate for Skepticism; the anti-thesis of these traits is existing as uninquisitive sheep. In this genesis of skeptical thinking, Bob excels. He is always thinking “what if?” and “why is it…?” and “how do you…?”, and I admire him very much for that. He stimulates my own thinking, and I’m the better for it.

But here’s where Bob gets derailed. Bob is magnificent when it comes to thinking outside the box, asking penetrating, thoughtful questions, seeing the world in novel and creative ways, and being very open-minded to hearing differing opinions and viewpoints. However, Bob never seeks answers to the questions he poses. Or at least he shows no real motivation to gain closure on his uncertainty. Like a three year old asking “Why is the sky blue?”, Bob thrives on the asking but gives not a whit about the response. He embraces the mystery of the unknowing, and in a way doesn’t really care if he is pointed toward a resolution to his query or not. He also doesn’t want to actually burn the calories to go through the trouble of looking something up or research his own uncertainties. Attempting to do the legwork required to solve one’s own intellectual conundrum, I believe, is another hallmark of being a good critical thinker and skeptic. Once the questions have been asked, now it’s the role and responsibility of the thinker to do a little heavy lifting and delve into the research. Evaluating evidence, sniffing out biases, fallacies, and other cognitive errors, and discerning fact from fiction allows the critical thinker to hone in on reality to the extent it can be known, and the process of doing one’s own detective work sharpens the skills necessary to become more astute and makes one less likely to be cast adrift in woo soup. Of course, we all start off as newcomers, and often we aren’t qualified to (or capable of) teasing back the layers of skeptical thinking to get an accurate picture of the answers we’re looking for. But just like the meatheads at the gym, we build our skeptical muscles by exercising them; we sharpen our skills by repeated use. And when we hit a roadblock or find ourselves out of our element, we turn to others for guidance. That’s how we learn, and perhaps in time we can mentor others.

Not Bob.

Bob throws out his question (which is usually an excellent and provocative one), counts one Mississippi, two Mississippi, three Mississippi- then it’s on to the next one. His rapid fire delivery is similar to the Gish Gallop, but unlike the Gallopers, he isn’t using his method to evade, confuse, and avoid; he sees something shiny and moves on to another topic. He means well, it’s just that his brain is like a trillion Pop Rocks vibrating in a skullbowl of caffeine jelly.

So what’s the harm?, one might ask. Let Bob be Bob; quit bashing him and allow him his right to let his hummingbird curiosity run amok. To that, I say you’re right. Bob can do whatever Bob wants; he’s a grown taxpayer and it’s a free country. That all said, the harm is that despite his inquisitiveness and his intelligence, since Bob doesn’t anchor his thoughts on a solid foundation of evidence based data, he tends to veer off course and get lured into some harebrained territories- from 9/11 Truthers, to alternative medicine ideas, as well as fringe political and philosophical areas. He isn’t grounded in the known, the proven; he’s all over the map and cognitively inconsistent. A veritable roulette wheel is spinning in his head constantly, and where she stops, nobody knows.

I call Bob a “Half a Skeptic,” a person who has the makings of a critical thinker, who initiates the launch sequence of critical thinking, but lacks the follow-through and the closure. Also known as a Stunted Skeptic, a Pseudo-Skeptic, or an Embryonic Skeptic, such a person might have the potential to evolve into a full-fledged, bona fide Skeptic, or they may languish, as does Bob, in a cerebral limbo where questions are asked but not answered. Although this post is one big lament of this condition, I actually wish there were more Half Skeptics. Why? Because half a skeptic is better than no skeptic at all, and it’s the “no skeptic” demographic that not only is in the majority in the U.S. and worldwide, but is the most pernicious and dangerous to open discourse and rational inquiry.